Provider Demographics
NPI:1124010319
Name:PIPOVSKI, LAZO S (MD)
Entity Type:Individual
Prefix:DR
First Name:LAZO
Middle Name:S
Last Name:PIPOVSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 MARQUESAS CIR STE 107
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3343
Mailing Address - Country:US
Mailing Address - Phone:941-702-5972
Mailing Address - Fax:941-217-6990
Practice Address - Street 1:5602 MARQUESAS CIR STE 107
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233
Practice Address - Country:US
Practice Address - Phone:941-702-5972
Practice Address - Fax:941-217-6990
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66275207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390008288OtherMEDICARE RR
FL25977OtherBCBS
FL377152100Medicaid
FL25977OtherBCBS
FLF92284Medicare UPIN
FL25977OtherBCBS